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16 pages, 692 KiB

Open AccessArticle

A Serious Game for the Prevention of Obesity in School Children–Impact of Parent’s Involvement: A Randomized Controlled Trial

by Alisa Weiland, Nadine Reiband, Norbert Schäffeler, Guido Zurstiege, Katrin Elisabeth Giel, Stephan Zipfel and Isabelle Mack

Life 2022, 12(6), 779; https://doi.org/10.3390/life12060779 - 24 May 2022

Cited by 3 | Viewed by 1910

Abstract

Serious games convey information and use interactive components to reinforce and train behaviours. A serious game addressing nutrition, physical activity and stress coping—the Kids Obesity Prevention Program (KOP)—was previously evaluated for efficacy in children. This study aimed at evaluating the KOP-game regarding: (i) [...] Read more.

Serious games convey information and use interactive components to reinforce and train behaviours. A serious game addressing nutrition, physical activity and stress coping—the Kids Obesity Prevention Program (KOP)—was previously evaluated for efficacy in children. This study aimed at evaluating the KOP-game regarding: (i) its acceptance and efficacy with respect to parents of primary school children receiving the same game intervention as the children; and (ii) whether the children could benefit by parental involvement. A randomized controlled trial with two groups of children aged 9 to 12 years was conducted which included a 6-month follow-up period. All children played the game twice in two weeks. In the family-intervention group, the parents additionally played the game. The primary outcome was the gain in knowledge in parents and children measured with a pretested questionnaire. The secondary outcomes were knowledge maintenance as well as several behavior changes. Parents and children in both groups improved and maintained their knowledge equally. The KOP-game increases knowledge of nutrition in children independently of the involvement of their parents. KOP games are well accepted in children; further research should examine the structured involvement of parents. Full article

(This article belongs to the Special Issue Pediatric Nutrition for a Healthy Life)

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18 pages, 273 KiB

Open AccessArticle

Learning from the Community to Predict Nutrition Status of Children Aged 6–24 Months in Gulu District, Northern Uganda: A Case Control Study

by Muzafaru Ssenyondo, Hanifa Bachou, Richard Bukenya, Richard Kajjura and David Guwatudde

Life 2022, 12(5), 664; https://doi.org/10.3390/life12050664 - 29 Apr 2022

Viewed by 1909

Abstract

The feeding and caring practices of infants and young children are critical to children’s nutrition status and development milestones. Most nutrition studies have focused on unfavorable factors that contribute to malnutrition rather than favorable factors that promote good nutrition status among children. This [...] Read more.

The feeding and caring practices of infants and young children are critical to children’s nutrition status and development milestones. Most nutrition studies have focused on unfavorable factors that contribute to malnutrition rather than favorable factors that promote good nutrition status among children. This study aimed at identifying predictors of normal nutrition status among children aged 6–24 months in Gulu District, Northern Uganda. A matched case-control study was conducted on a sample of 300 (i.e., 100 cases and 200 controls) purposively selected children during October–December 2021. Controls were children that had normal nutrition status, whereas cases with undernourished children had at least one type of undernutrition. Logistic regression was used to determine the predictors of good nutrition status using odds ratios (ORs). The mean age of the cases and controls was 15 months (SD ± 6) and 13 months (SD ± 5), respectively. At multivariable analysis, breastfeeding in the first hour of the child’s life (AOR = 3.31 95% CI. 1.52–7.23), use of family planning (AOR = 2.21 95% CI. 1.25–3.90), number of under-fives in the household (AOR = 0.31 95% CI. 0.13–0.73) and hand washing with soap (AOR = 3.63 95% CI. 1.76–7.49) were significantly independently associated with a child’s good nutrition status. Interventions that can improve children’s nutrition status include breastfeeding in the first hour of child’s life, use of family planning methods, child spacing and hand washing with soap. Full article

(This article belongs to the Special Issue Pediatric Nutrition for a Healthy Life)

15 pages, 1255 KiB

Open AccessArticle

Human Milk Macronutrients and Bioactive Molecules and Development of Regional Fat Depots in Western Australian Infants during the First 12 Months of Lactation

by Zoya Gridneva, Alethea Rea, Ching Tat Lai, Wan Jun Tie, Sambavi Kugananthan, Ashleigh H. Warden, Sharon L. Perrella, Kevin Murray and Donna T. Geddes

Life 2022, 12(4), 493; https://doi.org/10.3390/life12040493 - 28 Mar 2022

Cited by 4 | Viewed by 2039

Abstract

We investigated associations between intakes of human milk (HM) components (macronutrients and biologically active molecules) and regional fat depots development in healthy term infants (n = 20) across the first year of lactation. Infant limb (mid-arm and mid-thigh) lean and fat areas [...] Read more.

We investigated associations between intakes of human milk (HM) components (macronutrients and biologically active molecules) and regional fat depots development in healthy term infants (n = 20) across the first year of lactation. Infant limb (mid-arm and mid-thigh) lean and fat areas were assessed by ultrasound imaging at 2, 5, 9 and 12 months of age. Concentrations of HM total protein, whey protein, casein, adiponectin, leptin, lysozyme, lactoferrin, secretory IGA, total carbohydrates, lactose, HM oligosaccharides (total HMO, calculated) and infant 24-h milk intake were measured, and infant calculated daily intakes (CDI) of HM components were determined. This pilot study shows higher 24-h milk intake was associated with a larger mid-arm fat area (p = 0.024), higher breastfeeding frequency was associated with larger mid-arm (p = 0.008) and mid-thigh (p < 0.001) fat areas. Lysozyme (p = 0.001) and HMO CDI (p = 0.004) were time-dependently associated with the mid-arm fat area. Intakes of HM components and breastfeeding parameters may modulate infant limb fat depots development during the first year of age and potentially promote favorable developmental programming of infant body composition; however, further studies are needed to confirm these findings. Full article

(This article belongs to the Special Issue Pediatric Nutrition for a Healthy Life)

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18 pages, 465 KiB

Open AccessArticle

Complementary Feeding Indicators in Relation to Micronutrient Status of Ghanaian Children Aged 6–23 Months: Results from a National Survey

by William E. S. Donkor, Seth Adu-Afarwuah, Rita Wegmüller, Helena Bentil, Nicolai Petry, Fabian Rohner and James P. Wirth

Life 2021, 11(9), 969; https://doi.org/10.3390/life11090969 - 15 Sep 2021

Cited by 7 | Viewed by 3241

Abstract

Background: Optimal complementary feeding is critical for adequate growth and development in infants and young children. The associations between complementary feeding and growth have been studied well, but less is known about the relationship between complementary feeding and micronutrient status. Methods: Using data [...] Read more.

Background: Optimal complementary feeding is critical for adequate growth and development in infants and young children. The associations between complementary feeding and growth have been studied well, but less is known about the relationship between complementary feeding and micronutrient status. Methods: Using data from a national cross-sectional survey conducted in Ghana in 2017, we examined how multiple WHO-recommended complementary feeding indicators relate to anemia and the micronutrient status of children aged 6–23 months. Results: In total, 42%, 38%, and 14% of the children met the criteria for minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD), respectively. In addition, 71% and 52% of the children consumed iron-rich foods and vitamin A-rich foods, respectively. The prevalence of anemia, iron deficiency (ID), iron deficiency anemia (IDA) and vitamin A deficiency (VAD) was 46%, 45%, 27%, and 10%, respectively. Inverse associations between MMF and socio-economic status were found, and MMF was associated with an increased risk of ID (55%; p < 0.013) and IDA (38%; p < 0.002). Conclusion: The pathways connecting complementary feeding and micronutrient status are complex. Findings related to MMF should be further investigated to ensure that complementary feeding programs account for the potential practice of frequent feeding with nutrient-poor foods. Full article

(This article belongs to the Special Issue Pediatric Nutrition for a Healthy Life)

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10 pages, 357 KiB

Open AccessArticle

Healthy and Balanced Nutrition for Children through Physical Education Classes

by Rubén Trigueros, Sergio González-Bernal, Jerónimo J. González-Bernal, Raquel de la Fuente-Anuncibay and José M. Aguilar-Parra

Life 2021, 11(7), 678; https://doi.org/10.3390/life11070678 - 11 Jul 2021

Cited by 1 | Viewed by 2804

Abstract

Introduction. In recent years, the rate of childhood obesity has been on the rise, currently standing at levels close to 20%. This means that one in five children is more likely to suffer from cardiovascular or metabolic diseases. Physical Education classes are [...] Read more.

Introduction. In recent years, the rate of childhood obesity has been on the rise, currently standing at levels close to 20%. This means that one in five children is more likely to suffer from cardiovascular or metabolic diseases. Physical Education classes are therefore an ideal way to raise awareness among children and their families about healthy and balanced eating habits. Method. A total of 113 primary school students, aged 9–12 years, participated in the study. In order to analyze the data, a structural equation model (SEM) was used to analyze the influence between the variables. Results. The SEM results revealed that a controlling social context showed a negative prediction of psychological need satisfaction and a positive prediction of frustration. However, an autonomy supportive social context showed a negative prediction of psychological need satisfaction and a positive prediction of psychological need satisfaction. Frustration of psychological needs was negatively related to motivation, whereas satisfaction was positively related to motivation. In turn, motivation was positively related to each of the factors of the theory of planned behaviour. Finally, intention to follow a healthy diet was positively related to the Mediterranean diet. Discussion. These results revealed the importance of social context and physical education classes in the adoption of a balanced diet. Full article

(This article belongs to the Special Issue Pediatric Nutrition for a Healthy Life)

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12 pages, 304 KiB

Open AccessArticle

Dietary Patterns and Oral Health Behaviours Associated with Caries Development from 4 to 7 Years of Age

by Cátia Carvalho Silva, Sandra Gavinha, Sofia Vilela, Rita Rodrigues, Maria Conceição Manso, Milton Severo, Carla Lopes and Paulo Melo

Life 2021, 11(7), 609; https://doi.org/10.3390/life11070609 - 24 Jun 2021

Cited by 5 | Viewed by 2390

Abstract

The association between modifiable risk factors and caries in children has been documented; however, most studies have been cross-sectional and have not considered the complexity of dietary factors and oral health habits. This study aimed to investigate the prospective association between dietary patterns [...] Read more.

The association between modifiable risk factors and caries in children has been documented; however, most studies have been cross-sectional and have not considered the complexity of dietary factors and oral health habits. This study aimed to investigate the prospective association between dietary patterns and oral health behaviours at 4 years of age and the development of new decayed, missing, and filled teeth (d_3–6mft/D_3–6MFT) over a period of three years. Participants were children from the Generation XXI population-based birth cohort. At 4 years of age, diet patterns were assessed using a food frequency questionnaire, with three dietary patterns being identified. For the purpose of capturing the new development of caries between 4 and 7 years of age, two dental outcomes were defined in the mixed dentition: “dental caries development” and “severe dental caries development” in the mixed dentition. Bivariate analysis and multivariate logistic regression were used. From 4 to 7 years of age, 51.2% of the children had at least one new d_3–6mft/D_3–6MFT and 27.4% had more than two new d_3–6mft/D_3–6MFT. Children belonging to the “energy-dense foods” (OR = 2.19; 95% CI: 1.20–4.00) and “snacking” (OR = 2.19; 95% CI: 1.41–3.41) dietary patterns at 4 years old were associated with severe dental caries development three years later. Preventive strategies should be implemented in an attempt to reduce snacking and the consumption of energy-dense, micronutrient-poor foods to promote children’s oral health. Full article

(This article belongs to the Special Issue Pediatric Nutrition for a Healthy Life)

12 pages, 246 KiB

Open AccessArticle

Sugar Intake: Are All Children Made of Sugar?

by Lucia Diani and Maria Luisa Forchielli

Life 2021, 11(5), 444; https://doi.org/10.3390/life11050444 - 14 May 2021

Cited by 8 | Viewed by 2476

Abstract

Introduction: A healthy diet is characterized by a variety of food and a balanced energy intake, which should accompany every human being since early childhood. Unfortunately, excessive consumption of protein, fat, and lately sugar are very common in developed countries. Sugar intakes are [...] Read more.

Introduction: A healthy diet is characterized by a variety of food and a balanced energy intake, which should accompany every human being since early childhood. Unfortunately, excessive consumption of protein, fat, and lately sugar are very common in developed countries. Sugar intakes are not easily quantifiable and comparable among subjects. Therefore, we decide to analyze dietary patterns in children of different ages and diets (with and without gluten) using a food and nutrient database and a new application called the “Zuccherometro”. Patients and methods: This is a descriptive observational study conducted among children that are recruited consecutively either during a pediatric evaluation or through a school survey. Sociodemographic, nutritional and anthropometric data, degree of physical activity, and presence of medical conditions are collected. Dietary intake data are obtained by a 24 h recall diet. Results: The study analyzes 400 children: 213 girls and 187 boys. The majority of children (70.7%) are in normal weight range with similar extreme values (6.5% obese and 6.7% underweight). Celiac disease is diagnosed in 186 children. Caloric intakes are in line with the recommendations in all age-distributed groups with the exception of adolescents (11–17 years old), whose caloric intake is lower than recommendations. Protein intakes, on the contrary, are always exceeding recommendations and are significantly elevated in preschool children, (more than three times the population reference intakes). As for sugar intakes, all the children except the 11–17 years adolescents exceed the recommended cut off of 15% of daily calories. The same trend is obtained using the “Zuccherometro” that shows different percentages of age-stratified children exceeding the reference values: 1–3 years, 59% of children; 4–6 years, 68%; 7–10 years, 39.8%; 11–14 years, 25.5%; 15–17 years, 24.5%. The sugar load consists of both natural or added sugars (fructose and lactose) in food or beverages. Sugar intakes are more generously consumed by all age-stratified controls than by celiac children with the exception of the youngest ones (1–3 years old) and male adolescents. Conclusion: Since high sugar intakes are constantly accompanying children during their growth, important dietary education and coordination between families and institutions are mandatory. Full article

(This article belongs to the Special Issue Pediatric Nutrition for a Healthy Life)

17 pages, 450 KiB

Open AccessArticle

Nutritional Characteristics, Sites of Origin, and Cost of Foods Consumed during School Hours and Their Relationship to Nutritional Status of Schoolchildren in Mexico City

by Gloria Martínez-Andrade, Marco González-Unzaga, Guillermina Romero-Quechol, Eugenia Mendoza, Jenny Vilchis-Gil and Ximena Duque

Life 2021, 11(5), 439; https://doi.org/10.3390/life11050439 - 14 May 2021

Cited by 1 | Viewed by 2360

Abstract

Access, nutritional characteristics, preferences, and cost can affect food intake at school. A cross-sectional study was performed to determine the nutritional characteristics, sites of origin, and cost of foods consumed during school hours. Three hundred and sixty-nine children from five public elementary schools [...] Read more.

Access, nutritional characteristics, preferences, and cost can affect food intake at school. A cross-sectional study was performed to determine the nutritional characteristics, sites of origin, and cost of foods consumed during school hours. Three hundred and sixty-nine children from five public elementary schools in Mexico City participated. The children gave information about the foods that they consumed five days out of the week during school hours, including the place of acquisition, cost of the food, and portion size. Anthropometric measurements of height and weight of the children were taken. Caloric consumption and percentage of recommended daily energy intake from food during school hours was determined. Children were 10.9 ± 0.9 years old; 55.6% were girls, 26% were overweight, 23% were obese, and 3.3% were of low height for age. The average calorie intake was 515 kilocalories (kcal) (boys, 535 kcal; girls, 476 kcal, p = 0.051); calorie intake was higher when school meal intakes included foods from home, school, and outside of school. No significant differences were found in calorie intake by children’s nutritional status. The cost in Mexican pesos per 100 kcal consumed showed differences according to the nutritional status of the children; it was 4.0 Mexican pesos for children with normal weight and 4.2 and 3.8 pesos in children who were overweight or obese, respectively. The information obtained in this study should be used to provide nutritional guidance. The food portion size intake during school hours should be reduced, and the food should come from one or at most two sites, because each extra food represents an increase in the total kilocalorie intake. Full article

(This article belongs to the Special Issue Pediatric Nutrition for a Healthy Life)

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12 pages, 909 KiB

Open AccessArticle

Creatine Levels in Patients with Phenylketonuria and Mild Hyperphenylalaninemia: A Pilot Study

by Elvira Verduci, Maria Teresa Carbone, Laura Fiori, Claudia Gualdi, Giuseppe Banderali, Claudia Carducci, Vincenzo Leuzzi, Giacomo Biasucci and Gian Vincenzo Zuccotti

Life 2021, 11(5), 425; https://doi.org/10.3390/life11050425 - 06 May 2021

Cited by 1 | Viewed by 2105

Abstract

Background: Creatine (Cr) levels are strongly dependent on diets, including animal-derived proteins. Cr is an important metabolite as it represents a source of stored energy to support physical performance and potentially sustain positive effects such as improving memory or intelligence. This study was [...] Read more.

Background: Creatine (Cr) levels are strongly dependent on diets, including animal-derived proteins. Cr is an important metabolite as it represents a source of stored energy to support physical performance and potentially sustain positive effects such as improving memory or intelligence. This study was planned to assess Cr levels in PKU children adhering to a diet low in phenylalanine (Phe) content and compared with those of children with mild hyperphenylalaninemia (MHP) on a free diet. Methods: This retrospective pilot study analyzed Cr levels from Guthrie cards in 25 PKU and 35 MHP subjects. Anthropomorphic and nutritional data of the study populations were assessed, compared and correlated. Results: Cr levels of PKU subjects were significantly lower than those of MHP subjects and correlated to the low intake of animal proteins. Although no deficiencies in PKU subjects were identified, PKU subjects were found to have a 26-fold higher risk of displaying Cr levels <25° percentile than MHP counterparts. Conclusions: This pilot study suggests that Cr levels might be concerningly low in PKU children adhering to a low-Phe diet. Confirmatory studies are needed in PKU patients of different age groups to assess Cr levels and the potential benefits on physical and intellectual performance of Cr supplementation. Full article

(This article belongs to the Special Issue Pediatric Nutrition for a Healthy Life)

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15 pages, 548 KiB

Open AccessArticle

Impact of a Nutrition-Related Community Intervention on the Quantity and Quality of Children’s School almuerzo

by Jenny Vilchis-Gil, Miguel Klünder-Klünder, Ximena Duque, Gloria Martínez-Andrade, Andrea Martínez-Almaráz, Brenda Beristain-Lujano and Samuel Flores-Huerta

Life 2021, 11(3), 253; https://doi.org/10.3390/life11030253 - 19 Mar 2021

Cited by 4 | Viewed by 2614

Abstract

Foods and beverages that schoolchildren carry in their lunchboxes have high energy values but lack plain water, fresh fruits and vegetables. A nutrition-related community intervention on the quantity and quality of school almuerzo was performed, in which four primary schools participated, as part [...] Read more.

Foods and beverages that schoolchildren carry in their lunchboxes have high energy values but lack plain water, fresh fruits and vegetables. A nutrition-related community intervention on the quantity and quality of school almuerzo was performed, in which four primary schools participated, as part of two groups: 225 children in the intervention group (IG) and 177 children in the control group (CG). The parents from the IG had access to a website where they could consult information on eating habits and physical activity or school almuerzo menus. They were sent weekly text messages on their mobile phones and attended in-person sessions. Anthropometric measurements and surveys were performed in both groups at the start of the study, as well as after 6 and 12 months. The school almuerzo was assessed by recording foods that the children brought in their lunchboxes. At baseline, 88% of children brought a school almuerzo, 37% fruit, 17% vegetables, 40% plain water and 50% sweet drinks. In both groups, 50% of children brought a school almuerzo with an energy value above the recommended value (>340 kcal) during follow-up; however, the percentage of children who brought sweet drinks decreased (p < 0.05), with sweet drinks contributing between 26% and 33% of the calories in the school almuerzo. In the IG, the quantity in milliliters of plain water increased at the end of the follow-up period (p = 0.044). From the point of view of food-and-beverage quantity and quality, school almuerzo were unhealthy for both groups. The intervention failed to increase the frequency with which parents provided children with school almuerzo or enhance the quality of the latter. Full article

(This article belongs to the Special Issue Pediatric Nutrition for a Healthy Life)

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16 pages, 830 KiB

Open AccessArticle

High-Temperature Short-Time and Holder Pasteurization of Donor Milk: Impact on Milk Composition

by Diana Escuder-Vieco, Juan M. Rodríguez, Irene Espinosa-Martos, Nieves Corzo, Antonia Montilla, Alba García-Serrano, M. Visitación Calvo, Javier Fontecha, José Serrano, Leónides Fernández and Carmen Rosa Pallás-Alonso

Life 2021, 11(2), 114; https://doi.org/10.3390/life11020114 - 03 Feb 2021

Cited by 11 | Viewed by 3179

Abstract

Holder pasteurization (HoP; 62.5 °C, 30 min) is commonly used to ensure the microbiological safety of donor human milk (DHM) but diminishes its nutritional properties. A high-temperature short-time (HTST) system was designed as an alternative for human milk banks. The objective of this [...] Read more.

Holder pasteurization (HoP; 62.5 °C, 30 min) is commonly used to ensure the microbiological safety of donor human milk (DHM) but diminishes its nutritional properties. A high-temperature short-time (HTST) system was designed as an alternative for human milk banks. The objective of this study was to evaluate the effect of this HTST system on different nutrients and the bile salt stimulated lipase (BSSL) activity of DHM. DHM was processed in the HTST system and by standard HoP. Macronutrients were measured with a mid-infrared analyzer. Lactose, glucose, myo-inositol, vitamins and lipids were assayed using chromatographic techniques. BSSL activity was determined using a kit. The duration of HTST treatment had a greater influence on the nutrient composition of DHM than did the tested temperature. The lactose concentration and the percentage of phospholipids and PUFAs were higher in HTST-treated than in raw DHM, while the fat concentration and the percentage of monoacylglycerides and SFAs were lower. Other nutrients did not change after HTST processing. The retained BSSL activity was higher after short HTST treatment than that following HoP. Overall, HTST treatment resulted in better preservation of the nutritional quality of DHM than HoP because relevant thermosensitive components (phospholipids, PUFAs, and BSSL) were less affected. Full article

(This article belongs to the Special Issue Pediatric Nutrition for a Healthy Life)

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9 pages, 603 KiB

Open AccessArticle

Breastfeeding: Biological and Social Variables in Different Modes of Conception

by Paola Pileri, Ilenia di Bartolo, Martina Ilaria Mazzocco, Giovanni Casazza, Sofia Giani, Irene Cetin and Valeria Maria Savasi

Life 2021, 11(2), 110; https://doi.org/10.3390/life11020110 - 01 Feb 2021

Cited by 4 | Viewed by 2081

Abstract

Background: Breastfeeding has effects on health throughout the lives of mothers and babies. In 2014 in Italy, 10,976 babies were born through ART (assisted reproductive technology), accounting for 2.2% of annual births. The study aims to assess how both social and biological variables [...] Read more.

Background: Breastfeeding has effects on health throughout the lives of mothers and babies. In 2014 in Italy, 10,976 babies were born through ART (assisted reproductive technology), accounting for 2.2% of annual births. The study aims to assess how both social and biological variables and the mode of conception influence breastfeeding. Methods: This observational study involves 161 pregnancies from three different modes of conception: homologous in vitro fertilization, ovum donation, and spontaneous pregnancies. Neonatal and maternal characteristics were collected from the hospital database, while breastfeeding outcomes were obtained through telephone interviews. Results: The mode of conception did not influence any of the breastfeeding outcomes. Breastfeeding duration was negatively affected by smoking. Vaginal delivery, birth weight > 2500 g, delivery > 37 gestational weeks, breastfeeding intention, and rooming-in are positively associated with the initiation of breastfeeding, while skin-to-skin contact and receiving information concerning breastfeeding are the most significant variables associated with its exclusivity and duration. Conclusions: The duration and exclusivity of breastfeeding are mainly related with information thereon, promotion, and breastfeeding support, but not with the mode of conception. It is essential to adequately support women from the outset in breastfeeding, as recommended by the World Health Organization (WHO) guidelines. Full article

(This article belongs to the Special Issue Pediatric Nutrition for a Healthy Life)

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9 pages, 1116 KiB

Open AccessArticle

Methods to Assess Fat Mass in Infants and Young Children: A Comparative Study Using Skinfold Thickness and Air-Displacement Plethysmography

by Stefanie M. P. Kouwenhoven, Nadja Antl, Jos W. R. Twisk, Berthold V. Koletzko, Martijn J. J. Finken and Johannes B. van Goudoever

Life 2021, 11(2), 75; https://doi.org/10.3390/life11020075 - 20 Jan 2021

Cited by 4 | Viewed by 2086

Abstract

Background: Traditionally, fat mass is estimated using anthropometric models. Air-displacement plethysmography (ADP) is a relatively new technique for determining fat mass. There is limited information on the agreement between these methods in infants and young children. Therefore we aimed to longitudinally compare fat [...] Read more.

Background: Traditionally, fat mass is estimated using anthropometric models. Air-displacement plethysmography (ADP) is a relatively new technique for determining fat mass. There is limited information on the agreement between these methods in infants and young children. Therefore we aimed to longitudinally compare fat mass percentage values predicted from skinfold thicknesses (SFTs) and ADP in healthy infants and young children. Methods: Anthropometry and body composition were determined at the ages of 1, 4, and 6 months and 2 years. We quantified the agreement between the two methods using the Bland–Altman procedure, linear mixed-model analysis, and intra-class correlation coefficients (ICC). Results: During the first 6 months of life, fat mass% predicted with SFT was significantly different from that measured with ADP in healthy, term-born infants (n = 245). ICCs ranged from 0.33 (at 2 years of age) and 0.47 (at 4 months of age). Although the mean difference (bias) between the methods was low, the Bland–Altman plots showed proportional differences at all ages with wide limits of agreement. Conclusions: There is poor agreement between ADP and SFTs for estimating fat mass in infancy or early childhood. The amount of body fat was found to influence the agreement between the methods. Full article

(This article belongs to the Special Issue Pediatric Nutrition for a Healthy Life)

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Review

Jump to: Research

17 pages, 5065 KiB

Open AccessReview

An Overview of the Possible Exposure of Infants to Microplastics

by Csilla Mišľanová, Martina Valachovičová and Zuzana Slezáková

Life 2024, 14(3), 371; https://doi.org/10.3390/life14030371 - 12 Mar 2024

Viewed by 1516

Abstract

Microplastics are small plastic pieces with sizes less than 5 mm. They are becoming a global concern due to the potential risk to human health. The potential risks of microplastics may be greater for infants because they do not have sufficiently developed metabolizing [...] Read more.

Microplastics are small plastic pieces with sizes less than 5 mm. They are becoming a global concern due to the potential risk to human health. The potential risks of microplastics may be greater for infants because they do not have sufficiently developed metabolizing enzymes, have less ability to remove microplastics, and have highly sensitive target organs. Infants should be breastfed for the first six months of life. Breast milk is considered to be the most complete and suitable source of nutrition. However, if breastfeeding during this period is not possible, it is necessary to use formulas designed for infant initial feeding. Infants may be exposed to higher levels of MPs through infant foods or plastic products. The aim of this study is to describe the possible sources of exposure to microplastics such as the human placenta, plastic feeding bottles, and toys as well as the presence of released microplastics in infant feces, breast milk, and infant formulas. There is still not enough data available for this study area. Therefore, it is necessary to pay increased attention to minimizing the negative effects of microplastics on human health. Full article

(This article belongs to the Special Issue Pediatric Nutrition for a Healthy Life)

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17 pages, 825 KiB

Open AccessReview

Therapeutic Potential of Gut Microbiota and Its Metabolite Short-Chain Fatty Acids in Neonatal Necrotizing Enterocolitis

by Naser A. Alsharairi

Life 2023, 13(2), 561; https://doi.org/10.3390/life13020561 - 16 Feb 2023

Cited by 12 | Viewed by 2769

Abstract

Short chain fatty acids (SCFAs), the principle end-products produced by the anaerobic gut microbial fermentation of complex carbohydrates (CHO) in the colon perform beneficial roles in metabolic health. Butyrate, acetate and propionate are the main SCFA metabolites, which maintain gut homeostasis and host [...] Read more.

Short chain fatty acids (SCFAs), the principle end-products produced by the anaerobic gut microbial fermentation of complex carbohydrates (CHO) in the colon perform beneficial roles in metabolic health. Butyrate, acetate and propionate are the main SCFA metabolites, which maintain gut homeostasis and host immune responses, enhance gut barrier integrity and reduce gut inflammation via a range of epigenetic modifications in DNA/histone methylation underlying these effects. The infant gut microbiota composition is characterized by higher abundances of SCFA-producing bacteria. A large number of in vitro/vivo studies have demonstrated the therapeutic implications of SCFA-producing bacteria in infant inflammatory diseases, such as obesity and asthma, but the application of gut microbiota and its metabolite SCFAs to necrotizing enterocolitis (NEC), an acute inflammatory necrosis of the distal small intestine/colon affecting premature newborns, is scarce. Indeed, the beneficial health effects attributed to SCFAs and SCFA-producing bacteria in neonatal NEC are still to be understood. Thus, this literature review aims to summarize the available evidence on the therapeutic potential of gut microbiota and its metabolite SCFAs in neonatal NEC using the PubMed/MEDLINE database. Full article

(This article belongs to the Special Issue Pediatric Nutrition for a Healthy Life)

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27 pages, 510 KiB

Open AccessReview

The Role of Macronutrients in the Pathogenesis, Prevention and Treatment of Non-Alcoholic Fatty Liver Disease (NAFLD) in the Paediatric Population—A Review

by Thomas Pixner, Nathalie Stummer, Anna Maria Schneider, Andreas Lukas, Karin Gramlinger, Valérie Julian, David Thivel, Katharina Mörwald, Katharina Maruszczak, Harald Mangge, Julian Gomahr, Daniel Weghuber and Dieter Furthner

Life 2022, 12(6), 839; https://doi.org/10.3390/life12060839 - 05 Jun 2022

Cited by 3 | Viewed by 2754

Abstract

Paediatric non-alcoholic fatty liver disease (NAFLD) has become the most common chronic liver disease in childhood. Obesity is the main risk factor. Nutrition and lifestyle are the key elements in preventing and treating NAFLD in the absence of approved drug therapy. Whilst recommendations [...] Read more.

Paediatric non-alcoholic fatty liver disease (NAFLD) has become the most common chronic liver disease in childhood. Obesity is the main risk factor. Nutrition and lifestyle are the key elements in preventing and treating NAFLD in the absence of approved drug therapy. Whilst recommendations and studies on macronutrients (carbohydrates, fat and protein) in adult NAFLD exist, the discussion of this topic in paediatric NAFLD remains contradictory. The purpose of this review is to provide state-of-the-art knowledge on the role of macronutrients in paediatric NAFLD regarding quality and quantity. PubMed was searched and original studies and review articles were included in this review. Fructose, sucrose, saturated fatty acids, trans-fatty acids and ω-6-fatty-acids are strongly associated with paediatric NAFLD. High consumption of fibre, diets with a low glycaemic index, mono-unsaturated-fatty-acids and ω-3-fatty-acids reduce the risk of childhood-onset NAFLD. Data regarding the role of dietary protein in NAFLD are contradictory. No single diet is superior in treating paediatric NAFLD, although the composition of macronutrients in the Mediterranean Diet appears beneficial. Moreover, the optimal proportions of total macronutrients in the diet of paediatric NAFLD patients are unknown. Maintaining a eucaloric diet and avoiding saturated fatty acids, simple sugars (mainly fructose) and a high-caloric Western Diet are supported by literature. Full article

(This article belongs to the Special Issue Pediatric Nutrition for a Healthy Life)

11 pages, 776 KiB

Open AccessReview

How to Provide Breast Milk for the Preterm Infant and Avoid Symptomatic Cytomegalovirus Infection with Possible Long-Term Sequelae

by Bernhard Resch

Life 2022, 12(4), 504; https://doi.org/10.3390/life12040504 - 30 Mar 2022

Cited by 5 | Viewed by 2983

Abstract

Cytomegalovirus (CMV) is able to replicate in the breast milk of lactating mothers and thus the offspring might be affected by mild to severe symptoms of postnatal CMV disease in case of prematurity; not in term infants. Sepsis-like syndrome affects only very low [...] Read more.

Cytomegalovirus (CMV) is able to replicate in the breast milk of lactating mothers and thus the offspring might be affected by mild to severe symptoms of postnatal CMV disease in case of prematurity; not in term infants. Sepsis-like syndrome affects only very low birth infants; and few cases have been reported. The neurodevelopmental long-term outcome of those preterm infants revealed possible subtle deficiencies, but no major neurodevelopmental impairment. Neurodevelopmental sequelae are still in discussion and seem somewhat overestimated after careful evaluation of the published evidence. The main focus of postnatal CMV disease lies upon the extremely low birth weight of infants. Elimination of CMV is provided by short-term heating methods like the most widely used Holder pasteurization. Freezing and thawing methods leave a risk for CMV acquisition. The benefits of untreated breast milk have to be considered to outweigh the possible sequelae of postnatal CMV infection in the most vulnerable preterm infants. Full article

(This article belongs to the Special Issue Pediatric Nutrition for a Healthy Life)

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31 pages, 1971 KiB

Open AccessReview

The Role of Pediatric Nutrition as a Modifiable Risk Factor for Precocious Puberty

by Valeria Calcaterra, Elvira Verduci, Vittoria Carlotta Magenes, Martina Chiara Pascuzzi, Virginia Rossi, Arianna Sangiorgio, Alessandra Bosetti, Gianvincenzo Zuccotti and Chiara Mameli

Life 2021, 11(12), 1353; https://doi.org/10.3390/life11121353 - 07 Dec 2021

Cited by 13 | Viewed by 10250

Abstract

Puberty is a critical phase of growth and development characterized by a complex process regulated by the neuroendocrine system. Precocious puberty (PP) is defined as the appearance of physical and hormonal signs of pubertal development at an earlier age than is considered normal. [...] Read more.

Puberty is a critical phase of growth and development characterized by a complex process regulated by the neuroendocrine system. Precocious puberty (PP) is defined as the appearance of physical and hormonal signs of pubertal development at an earlier age than is considered normal. The timing of puberty has important public health, clinical, and social implications. In fact, it is crucial in psychological and physical development and can impact future health. Nutritional status is considered as one of the most important factors modulating pubertal development. This narrative review presents an overview on the role of nutritional factors as determinants of the timing of sexual maturation, focusing on early-life and childhood nutrition. As reported, breast milk seems to have an important protective role against early puberty onset, mainly due to its positive influence on infant growth rate and childhood overweight prevention. The energy imbalance, macro/micronutrient food content, and dietary patterns may modulate the premature activation of the hypothalamic–pituitary–gonadal axis, inducing precocious activation of puberty. An increase in knowledge on the mechanism whereby nutrients may influence puberty will be useful in providing adequate nutritional recommendations to prevent PP and related complications. Full article

(This article belongs to the Special Issue Pediatric Nutrition for a Healthy Life)

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14 pages, 5715 KiB

Open AccessReview

The Interplay of Nutriepigenomics, Personalized Nutrition and Clinical Practice in Managing Food Allergy

by Adli Ali, Nur Hana Hamzaid and Noor Akmal Shareela Ismail

Life 2021, 11(11), 1275; https://doi.org/10.3390/life11111275 - 22 Nov 2021

Cited by 2 | Viewed by 2798

Abstract

Food allergy in children has been a common issue due to the challenges of prescribing personalized nutrition with a lack of nutriepigenomics data. This has indeed further influenced clinical practice for appropriate management. While allergen avoidance is still the main principle in food [...] Read more.

Food allergy in children has been a common issue due to the challenges of prescribing personalized nutrition with a lack of nutriepigenomics data. This has indeed further influenced clinical practice for appropriate management. While allergen avoidance is still the main principle in food allergy management, we require more information to advance the science behind nutrition, genes, and the immune system. Many researchers have highlighted the importance of personalized nutrition but there is a lack of data on how the decision is made. Thus, this review highlights the relationship among these key players in identifying the solution to the clinical management of food allergy with current nutriepigenomics data. The discussion integrates various inputs, including clinical assessments, biomarkers, and epigenetic information pertaining to food allergy, to curate a holistic and personalized approach to food allergy management in particular. Full article

(This article belongs to the Special Issue Pediatric Nutrition for a Healthy Life)

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15 pages, 327 KiB

Open AccessReview

Nutritional Strategies for Childhood Obesity Prevention

by Elena Fornari, Marco Brusati and Claudio Maffeis

Life 2021, 11(6), 532; https://doi.org/10.3390/life11060532 - 08 Jun 2021

Cited by 8 | Viewed by 4244

Abstract

Background: Reducing the spread of obesity represents a challenge for clinicians in which obesity prevention plays a key role in achieving this purpose. The aim of this review is to analyze the nutritional interventions that can be implemented to prevent childhood obesity. Methods: [...] Read more.

Background: Reducing the spread of obesity represents a challenge for clinicians in which obesity prevention plays a key role in achieving this purpose. The aim of this review is to analyze the nutritional interventions that can be implemented to prevent childhood obesity. Methods: Searching PubMed and Cochrane Library between 2019 and 2021. Further searching with no date range for articles selected for their specific relevance in the pediatric area or for their scientific relevance. A total of 871 articles were identified and 90 were included. Results: We organized the results of the selected articles into age groups, and according to the subjects targeted for interventions or to the site of interventions, reserving an in-depth analysis on specific nutritional aspects. Promotion of breastfeeding, reduction of protein content of formulated milks, and diet of the first 12–24 months, involving family and schools in interventions that promote physical activity and healthy diet, are promising strategies for reduction of the risk of obesity. To increase the efficacy of interventions, a multidimensional approach is crucial. Conclusions: A multidimensional approach, which takes into consideration different areas of intervention, is pivotal for childhood obesity prevention. Integrated programs involving several components (nutrition and physical activity at first) at different levels (individual, family, school, and institutional) are crucial. Full article

(This article belongs to the Special Issue Pediatric Nutrition for a Healthy Life)

21 pages, 7143 KiB

Open AccessReview

Personalized Nutrition Approach in Pregnancy and Early Life to Tackle Childhood and Adult Non-Communicable Diseases

by Shaikha Alabduljabbar, Sara Al Zaidan, Arun Prasath Lakshmanan and Annalisa Terranegra

Life 2021, 11(6), 467; https://doi.org/10.3390/life11060467 - 24 May 2021

Cited by 12 | Viewed by 4425

Abstract

The development of childhood and adult non-communicable diseases (NCD) is associated with environmental factors, starting from intrauterine life. A new theory finds the roots of epigenetic programming in parental gametogenesis, continuing during embryo development, fetal life, and finally in post-natal life. Maternal health [...] Read more.

The development of childhood and adult non-communicable diseases (NCD) is associated with environmental factors, starting from intrauterine life. A new theory finds the roots of epigenetic programming in parental gametogenesis, continuing during embryo development, fetal life, and finally in post-natal life. Maternal health status and poor nutrition are widely recognized as implications in the onset of childhood and adult diseases. Early nutrition, particularly breastfeeding, also plays a primary role in affecting the health status of an individual later in life. A poor maternal diet during pregnancy and lack of breastfeeding can cause a nutrient deficiency that affects the gut microbiota, and acts as a cofactor for many pathways, impacting the epigenetic controls and transcription of genes involved in the metabolism, angiogenesis, and other pathways, leading to NCDs in adult life. Both maternal and fetal genetic backgrounds also affect nutrient adsorption and functioning at the cellular level. This review discusses the most recent evidence on maternal nutrition and breastfeeding in the development of NCD, the potentiality of the omics technologies in uncovering the molecular mechanisms underlying it, with the future prospective of applying a personalized nutrition approach to prevent and treat NCD from the beginning of fetal life. Full article

(This article belongs to the Special Issue Pediatric Nutrition for a Healthy Life)

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11 pages, 972 KiB

Open AccessReview

Butyrate: A Link between Early Life Nutrition and Gut Microbiome in the Development of Food Allergy

by Margherita Di Costanzo, Nicoletta De Paulis and Giacomo Biasucci

Life 2021, 11(5), 384; https://doi.org/10.3390/life11050384 - 23 Apr 2021

Cited by 21 | Viewed by 5012

Abstract

Increased prevalence of food allergies in the last thirty years has been attributed to lifestyle changes in Westernized countries. Among the environmental factors, nutritional factors and their interaction with the gut microbiome in early life are thought to have an important role in [...] Read more.

Increased prevalence of food allergies in the last thirty years has been attributed to lifestyle changes in Westernized countries. Among the environmental factors, nutritional factors and their interaction with the gut microbiome in early life are thought to have an important role in the observed epidemiological change. The gut microbiome synthesizes bacterial metabolites, which represent a link among gut microbiome, nutrition, and immune system. The main metabolites produced by gut microbiome are short-chain fatty acids (SCFAs). SCFAs have multiple beneficial effects on human health including protective effects in autoimmune and inflammatory diseases. Among SCFAs, butyrate is essential for maintaining gut immune homeostasis and exerts a pivotal role in immune tolerance with strong anti-inflammatory effects in allergic diseases. Recent findings suggest that butyrate takes part in the development of immunological tolerance to food, especially in the first 1000 days of life. Herein, we provide a critical review of the scientific literature on the role of butyrate for prevention and treatment of food allergies with focus on the complex interplay among early life nutrition, gut microbiome, and immune system. Full article

(This article belongs to the Special Issue Pediatric Nutrition for a Healthy Life)

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16 pages, 2218 KiB

Open AccessReview

Early Prevention of Atherosclerosis: Detection and Management of Hypercholesterolaemia in Children and Adolescents

by Cristina Pederiva, Maria Elena Capra, Claudia Viggiano, Valentina Rovelli, Giuseppe Banderali and Giacomo Biasucci

Life 2021, 11(4), 345; https://doi.org/10.3390/life11040345 - 14 Apr 2021

Cited by 24 | Viewed by 3219

Abstract

Coronary heart disease (CHD) is the main cause of death and morbidity in the world. There is a strong evidence that the atherosclerotic process begins in childhood and that hypercholesterolaemia is a CHD major risk factor. Hypercholesterolaemia is a modifiable CHD risk factor [...] Read more.

Coronary heart disease (CHD) is the main cause of death and morbidity in the world. There is a strong evidence that the atherosclerotic process begins in childhood and that hypercholesterolaemia is a CHD major risk factor. Hypercholesterolaemia is a modifiable CHD risk factor and there is a tracking of hypercholesterolaemia from birth to adulthood. Familial hypercholesterolaemia (FH) is the most common primitive cause of hypercholesterolaemia, affecting 1:200–250 individuals. Early detection and treatment of hypercholesterolaemia in childhood can literally “save decades of life”, as stated in the European Atherosclerosis Society Consensus. Multiple screening strategies have been proposed. In 2008, the American Academy of Pediatrics published the criteria for targeted screening, while some expert panels recommend universal screening particularly in the young, although cost effectiveness has not been fully analysed. Blood lipid profile evaluation [total cholesterol, Low-Density Lipoprotein Cholesterol (LDL-C), High-Density Lipoprotein Cholesterol (HDL-C) and triglycerides] is the first step. It has to be ideally performed between two and ten years of age. Hypercholesterolaemia has to be confirmed with a second sample and followed by the detection of family history for premature (before 55 years in men and 60 years in women) or subsequent cardio-vascular events and/or hypercholesterolaemia in 1st and 2nd degree relatives. The management of hypercholesterolaemia in childhood primarily involves healthy lifestyle and a prudent low-fat diet, emphasising the benefits of the Mediterranean diet. Statins are the cornerstone of the drug therapy approved in USA and in Europe for use in children. Ezetimibe or bile acid sequestrants may be required to attain LDL-C goal in some patients. Early identification of children with severe hypercholesterolaemia or with FH is important to prevent atherosclerosis at the earliest stage of development, when maximum benefit can still be obtained via lifestyle adaptations and therapy. The purpose of our review is to highlight the importance of prevention and treatment of hypercholesterolaemia starting from the earliest stages of life. Full article

(This article belongs to the Special Issue Pediatric Nutrition for a Healthy Life)

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13 pages, 325 KiB

Open AccessReview

Overview of Important Micronutrients Supplementation in Preterm Infants after Discharge: A Call for Consensus

by Laura Ilardi, Alice Proto, Federica Ceroni, Daniela Morniroli, Stefano Martinelli, Fabio Mosca and Maria Lorella Giannì

Life 2021, 11(4), 331; https://doi.org/10.3390/life11040331 - 10 Apr 2021

Cited by 13 | Viewed by 3666

Abstract

Preterm infants have a lower level of nutrient body stores and immature body systems, resulting in a higher risk of malnutrition. Imbalanced complementary feeding could lead to further risk of nutritional deficits and excesses. However, evidence on their nutritional requirements following hospital discharge [...] Read more.

Preterm infants have a lower level of nutrient body stores and immature body systems, resulting in a higher risk of malnutrition. Imbalanced complementary feeding could lead to further risk of nutritional deficits and excesses. However, evidence on their nutritional requirements following hospital discharge is limited. When planning complementary feeding, appropriate micronutrient intake should be considered for their critical role in supporting various body functions. This narrative review summarizes the need for iron, zinc, vitamin D, calcium, phosphate and long-chain polyunsaturated fatty acids (LCPUFAs) supplementation in preterm infants during complementary feeding. Regarding iron and vitamin D, the scientific community is reaching an agreement on supplementation in some categories of prematures. On the contrary, there is still not enough evidence to detail possible recommendations for LCPUFAs, zinc, calcium and phosphorus supplementation. However, these micronutrients are paramount for preterms’ health: LCPUFAs can promote retinal and brain development while calcium and phosphorus supplementation is essential to prevent preterms’ metabolic bone disease (MBD). Waiting for a consensus on these micronutrients, it is clear how the knowledge of the heterogeneity of the prematures population can help adjust the nutritional planning regarding the growth rate, comorbidities and comprehensive clinical history of the preterm infant. Full article

(This article belongs to the Special Issue Pediatric Nutrition for a Healthy Life)

27 pages, 474 KiB

Open AccessReview

When a Neonate Is Born, So Is a Microbiota

by Alessandra Coscia, Flaminia Bardanzellu, Elisa Caboni, Vassilios Fanos and Diego Giampietro Peroni

Life 2021, 11(2), 148; https://doi.org/10.3390/life11020148 - 16 Feb 2021

Cited by 34 | Viewed by 5121

Abstract

In recent years, the role of human microbiota as a short- and long-term health promoter and modulator has been affirmed and progressively strengthened. In the course of one’s life, each subject is colonized by a great number of bacteria, which constitute its specific [...] Read more.

In recent years, the role of human microbiota as a short- and long-term health promoter and modulator has been affirmed and progressively strengthened. In the course of one’s life, each subject is colonized by a great number of bacteria, which constitute its specific and individual microbiota. Human bacterial colonization starts during fetal life, in opposition to the previous paradigm of the “sterile womb”. Placenta, amniotic fluid, cord blood and fetal tissues each have their own specific microbiota, influenced by maternal health and habits and having a decisive influence on pregnancy outcome and offspring outcome. The maternal microbiota, especially that colonizing the genital system, starts to influence the outcome of pregnancy already before conception, modulating fertility and the success rate of fertilization, even in the case of assisted reproduction techniques. During the perinatal period, neonatal microbiota seems influenced by delivery mode, drug administration and many other conditions. Special attention must be reserved for early neonatal nutrition, because breastfeeding allows the transmission of a specific and unique lactobiome able to modulate and positively affect the neonatal gut microbiota. Our narrative review aims to investigate the currently identified pre- and peri-natal factors influencing neonatal microbiota, before conception, during pregnancy, pre- and post-delivery, since the early microbiota influences the whole life of each subject. Full article

(This article belongs to the Special Issue Pediatric Nutrition for a Healthy Life)

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